Pediatric Radiology

, Volume 46, Issue 7, pp 1059–1067 | Cite as

Tonsil ultrasound: technical approach and spectrum of pediatric peritonsillar infections

  • Anjum N. BandarkarEmail author
  • Adebunmi O. Adeyiga
  • M. Taylor Fordham
  • Diego Preciado
  • Brian K. Reilly
Pictorial Essay


Peritonsillar infections are one of the most common deep neck space infections, particularly in adolescents. Inaccurate diagnosis can lead to delay in management and potentially life-threatening complications. Contrast-enhanced computed tomography (CT) scan of the neck traditionally has been used to diagnose suspected peritonsillar abscess. With growing concern over radiation exposure, there has been increasing utilization of ultrasound (US) using intraoral and transcutaneous approaches. We chose the transcutaneous US technique due to its ease of performance in children. The purpose of this article is twofold: a) to describe our technique of performing transcutaneous US of the tonsil showing sonographic appearance of normal tonsil, highlighting pertinent anatomy and unique considerations for this modality in children, and b) to illustrate the sonographic findings in the spectrum of pediatric peritonsillar infections, which includes uncomplicated tonsillitis, peritonsillar cellulitis, small intratonsillar abscess and frank peritonsillar abscess. Parapharyngeal abscess can sometimes be detected.


Abscess Children Infection Peritonsillar infection Tonsil Ultrasound 



We would like to express our sincere appreciation to our stellar sonographers - Cathy Brown Jones, Tara Cielma, Amanda George, Pamela Handelman, Megan Hartman, Danyelle Holley, Suella Jones, Kadine Linden, Linda Rebolo, Courtney Ruiz and Roza Zenelaj, for their expertise and insight. We are grateful to Dr. Asif Momin for his scientific guidance. We also thank Drs. Anna Blask and Eglal Shalaby-Rana for their critical comments.

Compliance with ethical standards

Conflicts of interest



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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Anjum N. Bandarkar
    • 1
    Email author
  • Adebunmi O. Adeyiga
    • 1
  • M. Taylor Fordham
    • 2
  • Diego Preciado
    • 3
  • Brian K. Reilly
    • 3
  1. 1.Division of Diagnostic Imaging and RadiologyChildren’s National Health SystemWashingtonUSA
  2. 2.Department of OtolaryngologyChildren’s Hospital of San AntonioSan AntonioUSA
  3. 3.Department of Pediatric OtolaryngologyChildren’s National Health SystemWashingtonUSA

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